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Новые возможности аллерген-специфической иммунотерапии
Новые возможности аллерген-специфической иммунотерапии
Павлова К.С. Новые возможности аллерген-специфической иммунотерапии. Педиатрия (Прил. к журн. Consilium Medicum). 2017; 4: 56–58.
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Аннотация
Аллерген-специфическая иммунотерапия (АСИТ) имеет более чем 100-летний опыт применения при лечении аллергического ринита и атопической бронхиальной астмы. АСИТ индуцирует толерантность к аллергенам посредством восстановления баланса иммунной системы; позволяет предупредить трансформацию аллергического ринита в бронхиальную астму и является единственным лечением аллергии с пролонгированным эффектом в отношении всех симптомов. Эффективность АСИТ доказана многими рандомизированными контролируемыми исследованиями и систематическими обзорами. Использование современных высокодозных сублингвальных лечебных аллергенов позволяет достигать столь же высоких результатов, как и при проведении подкожной АСИТ. При этом сублингвальная АСИТ имеет более высокий профиль безопасности относительно подкожной АСИТ, что делает ее предпочтительным выбором в педиатрической практике.
Ключевые слова: аллерген-специфическая иммунотерапия, сублингвальная аллерген-специфическая иммунотерапия, высокодозная аллерген-специфическая иммунотерапия, аллергический ринит, бронхиальная астма.
Key words: allergen immunotherapy, sublingual allergen immunotherapy, high-dose AIT, allergic rhinitis, bronchial asthma.
Ключевые слова: аллерген-специфическая иммунотерапия, сублингвальная аллерген-специфическая иммунотерапия, высокодозная аллерген-специфическая иммунотерапия, аллергический ринит, бронхиальная астма.
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Key words: allergen immunotherapy, sublingual allergen immunotherapy, high-dose AIT, allergic rhinitis, bronchial asthma.
Полный текст
Список литературы
1. Jutel M, Agache I, Bonini S et al. International Consensus On (ICON) Allergy Immunotherapy (AIT). J Allergy Clin Immunol 2015; 136 (3): 556–68.
2. Bousquet J, Lockey R, Malling HJ. WHO Position Paper. Allergen immunotherapy: therapeutic vaccines for allergic diseases. Allergy 1998; 53 (Suppl. 44): 1–42.
3. Курбачева О.М., Павлова К.С. Федеральные клинические рекомендации. Аллерген-специфическая иммунотерапия. РАЖ. 2016; 4–5: 55–61. / Kurbacheva O.M., Pavlova K.S. Federal'nye klinicheskie rekomendatsii. Allergen-spetsificheskaia immunoterapiia. RAZh. 2016; 4–5: 55–61. [in Russian]
4. Курбачева О.М., Павлова К.С., Галицкая М.А. Аллерген-специфическая иммунотерапия. Аналитический обзор современных международных и отечественных позиционных документов. РАЖ. 2017; 1: 24–32. / Kurbacheva O.M., Pavlova K.S., Galitskaia M.A. Allergen-spetsificheskaia immunoterapiia. Analiticheskii obzor sovremennykh mezhdunarodnykh i otechestvennykh pozitsionnykh dokumentov. RAZh. 2017; 1: 24–32. [in Russian]
5. Гущин И.С., Курбачева О.М. Аллергия и аллерген-специфическая иммунотерапия. М.: Фармарус Принт Медиа, 2010. / Gushchin I.S., Kurbacheva O.M. Allergiia i allergen-spetsificheskaia immunoterapiia. M.: Farmarus Print Media, 2010. [in Russian]
6. Jutel M, Agache I, Bonini S et al. International Consensus on Allergen Immunotherapy II: Mechanisms, standardization, and pharmacoeconomics. J Allergy Clin Immunol 2016; 137 (2): 358–68.
7. Eifan AO, Calderon MA, Durham SR. Allergen immunotherapy for house dust mite: clinical efficacy and immunological mechanisms in allergic rhinitis and asthma. Expert Opin Biol Ther 2013; 13 (11): 1543–56.
8. Radulvic S, Calderon MA, Wilson D, Durham S. Sublingual immunotherapy for allergic rhinitis. Cochrane Database Syst Rev 2010; 8 (12): CD002893.
9. Zielen S et al. Sublingual immunotherapy provides long-term relief in allergic rhinitis and reduces the risk of asthma: a retrospective, real-world database analysis. Allergy 2017. DOI: 10.1111/all.13213.
10. Akdis M, Schmidt-Weber C, Jutel M et al. Mechanisms of allergen immunotherapy. Allergy Clin Immunol Int – J World Allergy Org 2004; 16 (2): 65–9.
11. Calderon MA, Larenas D, Kleine-Tebbe J et al. European academy of allergy and clinical immunology task force report on ‘dose-response relationship in allergen-specific immunotherapy’. Allergy 2011; 66: 1345–59.
12. Didier A, Malling HJ, Worm M et al. Optimal dose, efficacy, and safety of once-daily sublingual immunotherapy with a 5-grass pollen tablet for seasonal allergic rhinitis. J Allergy Clin Immunol 2007; 120: 1338–45.
13. Durham SR, Yang WH, Pedersen MR et al. Sublingual immunotherapy with once-daily grass allergen tablets: a randomized controlled trial in seasonal allergic rhinoconjunctivitis. J Allergy Clin Immunol 2006; 117: 802–9.
14. Skoner D, Gentile D, Bush R et al. Sublingual immunotherapy in patients with allergic rhinoconjunctivitis caused by ragweed pollen. J Allergy Clin Immunol 2010; 125: 660–6.
15. Valovirta E, Jacobsen L, Ljorring C et al. Clinical efficacy and safety of sublingual immunotherapy with tree pollen extract in children. Allergy 2006; 61: 1177–83.
16. Khinchi MS, Poulsen LK, Carat F et al. Clinical efficacy of sublingual and subcutaneous birch pollen allergen-specific immunotherapy: a randomized, placebo-controlled, double-blind, double-dummy study. Allergy 2004; 59 (1): 45–53.
17. Novembre E, Galli E, Landi F et al. Coseasonal sublingual immunotherapy reduces the development of asthma in children with allergic rhinoconjunctivitis. J Allergy Clin Immunol 2004; 114: 851–7.
18. Pichler CE, Marquardsen A, Sparholt S et al. Specific immunotheraoy with Dermatophagoides pteronyssinus and D. farina results in decreased bronchial hyperreactivity. Allergy 1997; 52: 274–83.
19. Zielen S, Kardos P, Madonini E. Steroid-sparing effects with allergen-specific immunotherapy in children with asthma: a randomized controlled trial. J Allergy Clin Immunol 2010; 126 (5): 942–9.
20. Di Rienzo V, Marcucci F, Pucinelli P et al. Long-lasting effect of sublingual immunotherapy in children with asthma due to house dust mite: a 10-year prospective study. Clin Exp Allergy 2003; 33 (2): 206–10.
21. Nelson H, Cartier S, Allen-Ramey F et al. Network meta-analysis shows commercialized subcutaneous and sublingual grass products have comparable efficacy. J Allergy Clin Immunol Pract 2015; 3 (2): 256–66.
2. Bousquet J, Lockey R, Malling HJ. WHO Position Paper. Allergen immunotherapy: therapeutic vaccines for allergic diseases. Allergy 1998; 53 (Suppl. 44): 1–42.
3. Kurbacheva O.M., Pavlova K.S. Federal'nye klinicheskie rekomendatsii. Allergen-spetsificheskaia immunoterapiia. RAZh. 2016; 4–5: 55–61. [in Russian]
4. Kurbacheva O.M., Pavlova K.S., Galitskaia M.A. Allergen-spetsificheskaia immunoterapiia. Analiticheskii obzor sovremennykh mezhdunarodnykh i otechestvennykh pozitsionnykh dokumentov. RAZh. 2017; 1: 24–32. [in Russian]
5. Gushchin I.S., Kurbacheva O.M. Allergiia i allergen-spetsificheskaia immunoterapiia. M.: Farmarus Print Media, 2010. [in Russian]
6. Jutel M, Agache I, Bonini S et al. International Consensus on Allergen Immunotherapy II: Mechanisms, standardization, and pharmacoeconomics. J Allergy Clin Immunol 2016; 137 (2): 358–68.
7. Eifan AO, Calderon MA, Durham SR. Allergen immunotherapy for house dust mite: clinical efficacy and immunological mechanisms in allergic rhinitis and asthma. Expert Opin Biol Ther 2013; 13 (11): 1543–56.
8. Radulvic S, Calderon MA, Wilson D, Durham S. Sublingual immunotherapy for allergic rhinitis. Cochrane Database Syst Rev 2010; 8 (12): CD002893.
9. Zielen S et al. Sublingual immunotherapy provides long-term relief in allergic rhinitis and reduces the risk of asthma: a retrospective, real-world database analysis. Allergy 2017. DOI: 10.1111/all.13213.
10. Akdis M, Schmidt-Weber C, Jutel M et al. Mechanisms of allergen immunotherapy. Allergy Clin Immunol Int – J World Allergy Org 2004; 16 (2): 65–9.
11. Calderon MA, Larenas D, Kleine-Tebbe J et al. European academy of allergy and clinical immunology task force report on ‘dose-response relationship in allergen-specific immunotherapy’. Allergy 2011; 66: 1345–59.
12. Didier A, Malling HJ, Worm M et al. Optimal dose, efficacy, and safety of once-daily sublingual immunotherapy with a 5-grass pollen tablet for seasonal allergic rhinitis. J Allergy Clin Immunol 2007; 120: 1338–45.
13. Durham SR, Yang WH, Pedersen MR et al. Sublingual immunotherapy with once-daily grass allergen tablets: a randomized controlled trial in seasonal allergic rhinoconjunctivitis. J Allergy Clin Immunol 2006; 117: 802–9.
14. Skoner D, Gentile D, Bush R et al. Sublingual immunotherapy in patients with allergic rhinoconjunctivitis caused by ragweed pollen. J Allergy Clin Immunol 2010; 125: 660–6.
15. Valovirta E, Jacobsen L, Ljorring C et al. Clinical efficacy and safety of sublingual immunotherapy with tree pollen extract in children. Allergy 2006; 61: 1177–83.
16. Khinchi MS, Poulsen LK, Carat F et al. Clinical efficacy of sublingual and subcutaneous birch pollen allergen-specific immunotherapy: a randomized, placebo-controlled, double-blind, double-dummy study. Allergy 2004; 59 (1): 45–53.
17. Novembre E, Galli E, Landi F et al. Coseasonal sublingual immunotherapy reduces the development of asthma in children with allergic rhinoconjunctivitis. J Allergy Clin Immunol 2004; 114: 851–7.
18. Pichler CE, Marquardsen A, Sparholt S et al. Specific immunotheraoy with Dermatophagoides pteronyssinus and D. farina results in decreased bronchial hyperreactivity. Allergy 1997; 52: 274–83.
19. Zielen S, Kardos P, Madonini E. Steroid-sparing effects with allergen-specific immunotherapy in children with asthma: a randomized controlled trial. J Allergy Clin Immunol 2010; 126 (5): 942–9.
20. Di Rienzo V, Marcucci F, Pucinelli P et al. Long-lasting effect of sublingual immunotherapy in children with asthma due to house dust mite: a 10-year prospective study. Clin Exp Allergy 2003; 33 (2): 206–10.
21. Nelson H, Cartier S, Allen-Ramey F et al. Network meta-analysis shows commercialized subcutaneous and sublingual grass products have comparable efficacy. J Allergy Clin Immunol Pract 2015; 3 (2): 256–66.
2. Bousquet J, Lockey R, Malling HJ. WHO Position Paper. Allergen immunotherapy: therapeutic vaccines for allergic diseases. Allergy 1998; 53 (Suppl. 44): 1–42.
3. Курбачева О.М., Павлова К.С. Федеральные клинические рекомендации. Аллерген-специфическая иммунотерапия. РАЖ. 2016; 4–5: 55–61. / Kurbacheva O.M., Pavlova K.S. Federal'nye klinicheskie rekomendatsii. Allergen-spetsificheskaia immunoterapiia. RAZh. 2016; 4–5: 55–61. [in Russian]
4. Курбачева О.М., Павлова К.С., Галицкая М.А. Аллерген-специфическая иммунотерапия. Аналитический обзор современных международных и отечественных позиционных документов. РАЖ. 2017; 1: 24–32. / Kurbacheva O.M., Pavlova K.S., Galitskaia M.A. Allergen-spetsificheskaia immunoterapiia. Analiticheskii obzor sovremennykh mezhdunarodnykh i otechestvennykh pozitsionnykh dokumentov. RAZh. 2017; 1: 24–32. [in Russian]
5. Гущин И.С., Курбачева О.М. Аллергия и аллерген-специфическая иммунотерапия. М.: Фармарус Принт Медиа, 2010. / Gushchin I.S., Kurbacheva O.M. Allergiia i allergen-spetsificheskaia immunoterapiia. M.: Farmarus Print Media, 2010. [in Russian]
6. Jutel M, Agache I, Bonini S et al. International Consensus on Allergen Immunotherapy II: Mechanisms, standardization, and pharmacoeconomics. J Allergy Clin Immunol 2016; 137 (2): 358–68.
7. Eifan AO, Calderon MA, Durham SR. Allergen immunotherapy for house dust mite: clinical efficacy and immunological mechanisms in allergic rhinitis and asthma. Expert Opin Biol Ther 2013; 13 (11): 1543–56.
8. Radulvic S, Calderon MA, Wilson D, Durham S. Sublingual immunotherapy for allergic rhinitis. Cochrane Database Syst Rev 2010; 8 (12): CD002893.
9. Zielen S et al. Sublingual immunotherapy provides long-term relief in allergic rhinitis and reduces the risk of asthma: a retrospective, real-world database analysis. Allergy 2017. DOI: 10.1111/all.13213.
10. Akdis M, Schmidt-Weber C, Jutel M et al. Mechanisms of allergen immunotherapy. Allergy Clin Immunol Int – J World Allergy Org 2004; 16 (2): 65–9.
11. Calderon MA, Larenas D, Kleine-Tebbe J et al. European academy of allergy and clinical immunology task force report on ‘dose-response relationship in allergen-specific immunotherapy’. Allergy 2011; 66: 1345–59.
12. Didier A, Malling HJ, Worm M et al. Optimal dose, efficacy, and safety of once-daily sublingual immunotherapy with a 5-grass pollen tablet for seasonal allergic rhinitis. J Allergy Clin Immunol 2007; 120: 1338–45.
13. Durham SR, Yang WH, Pedersen MR et al. Sublingual immunotherapy with once-daily grass allergen tablets: a randomized controlled trial in seasonal allergic rhinoconjunctivitis. J Allergy Clin Immunol 2006; 117: 802–9.
14. Skoner D, Gentile D, Bush R et al. Sublingual immunotherapy in patients with allergic rhinoconjunctivitis caused by ragweed pollen. J Allergy Clin Immunol 2010; 125: 660–6.
15. Valovirta E, Jacobsen L, Ljorring C et al. Clinical efficacy and safety of sublingual immunotherapy with tree pollen extract in children. Allergy 2006; 61: 1177–83.
16. Khinchi MS, Poulsen LK, Carat F et al. Clinical efficacy of sublingual and subcutaneous birch pollen allergen-specific immunotherapy: a randomized, placebo-controlled, double-blind, double-dummy study. Allergy 2004; 59 (1): 45–53.
17. Novembre E, Galli E, Landi F et al. Coseasonal sublingual immunotherapy reduces the development of asthma in children with allergic rhinoconjunctivitis. J Allergy Clin Immunol 2004; 114: 851–7.
18. Pichler CE, Marquardsen A, Sparholt S et al. Specific immunotheraoy with Dermatophagoides pteronyssinus and D. farina results in decreased bronchial hyperreactivity. Allergy 1997; 52: 274–83.
19. Zielen S, Kardos P, Madonini E. Steroid-sparing effects with allergen-specific immunotherapy in children with asthma: a randomized controlled trial. J Allergy Clin Immunol 2010; 126 (5): 942–9.
20. Di Rienzo V, Marcucci F, Pucinelli P et al. Long-lasting effect of sublingual immunotherapy in children with asthma due to house dust mite: a 10-year prospective study. Clin Exp Allergy 2003; 33 (2): 206–10.
21. Nelson H, Cartier S, Allen-Ramey F et al. Network meta-analysis shows commercialized subcutaneous and sublingual grass products have comparable efficacy. J Allergy Clin Immunol Pract 2015; 3 (2): 256–66.
________________________________________________
2. Bousquet J, Lockey R, Malling HJ. WHO Position Paper. Allergen immunotherapy: therapeutic vaccines for allergic diseases. Allergy 1998; 53 (Suppl. 44): 1–42.
3. Kurbacheva O.M., Pavlova K.S. Federal'nye klinicheskie rekomendatsii. Allergen-spetsificheskaia immunoterapiia. RAZh. 2016; 4–5: 55–61. [in Russian]
4. Kurbacheva O.M., Pavlova K.S., Galitskaia M.A. Allergen-spetsificheskaia immunoterapiia. Analiticheskii obzor sovremennykh mezhdunarodnykh i otechestvennykh pozitsionnykh dokumentov. RAZh. 2017; 1: 24–32. [in Russian]
5. Gushchin I.S., Kurbacheva O.M. Allergiia i allergen-spetsificheskaia immunoterapiia. M.: Farmarus Print Media, 2010. [in Russian]
6. Jutel M, Agache I, Bonini S et al. International Consensus on Allergen Immunotherapy II: Mechanisms, standardization, and pharmacoeconomics. J Allergy Clin Immunol 2016; 137 (2): 358–68.
7. Eifan AO, Calderon MA, Durham SR. Allergen immunotherapy for house dust mite: clinical efficacy and immunological mechanisms in allergic rhinitis and asthma. Expert Opin Biol Ther 2013; 13 (11): 1543–56.
8. Radulvic S, Calderon MA, Wilson D, Durham S. Sublingual immunotherapy for allergic rhinitis. Cochrane Database Syst Rev 2010; 8 (12): CD002893.
9. Zielen S et al. Sublingual immunotherapy provides long-term relief in allergic rhinitis and reduces the risk of asthma: a retrospective, real-world database analysis. Allergy 2017. DOI: 10.1111/all.13213.
10. Akdis M, Schmidt-Weber C, Jutel M et al. Mechanisms of allergen immunotherapy. Allergy Clin Immunol Int – J World Allergy Org 2004; 16 (2): 65–9.
11. Calderon MA, Larenas D, Kleine-Tebbe J et al. European academy of allergy and clinical immunology task force report on ‘dose-response relationship in allergen-specific immunotherapy’. Allergy 2011; 66: 1345–59.
12. Didier A, Malling HJ, Worm M et al. Optimal dose, efficacy, and safety of once-daily sublingual immunotherapy with a 5-grass pollen tablet for seasonal allergic rhinitis. J Allergy Clin Immunol 2007; 120: 1338–45.
13. Durham SR, Yang WH, Pedersen MR et al. Sublingual immunotherapy with once-daily grass allergen tablets: a randomized controlled trial in seasonal allergic rhinoconjunctivitis. J Allergy Clin Immunol 2006; 117: 802–9.
14. Skoner D, Gentile D, Bush R et al. Sublingual immunotherapy in patients with allergic rhinoconjunctivitis caused by ragweed pollen. J Allergy Clin Immunol 2010; 125: 660–6.
15. Valovirta E, Jacobsen L, Ljorring C et al. Clinical efficacy and safety of sublingual immunotherapy with tree pollen extract in children. Allergy 2006; 61: 1177–83.
16. Khinchi MS, Poulsen LK, Carat F et al. Clinical efficacy of sublingual and subcutaneous birch pollen allergen-specific immunotherapy: a randomized, placebo-controlled, double-blind, double-dummy study. Allergy 2004; 59 (1): 45–53.
17. Novembre E, Galli E, Landi F et al. Coseasonal sublingual immunotherapy reduces the development of asthma in children with allergic rhinoconjunctivitis. J Allergy Clin Immunol 2004; 114: 851–7.
18. Pichler CE, Marquardsen A, Sparholt S et al. Specific immunotheraoy with Dermatophagoides pteronyssinus and D. farina results in decreased bronchial hyperreactivity. Allergy 1997; 52: 274–83.
19. Zielen S, Kardos P, Madonini E. Steroid-sparing effects with allergen-specific immunotherapy in children with asthma: a randomized controlled trial. J Allergy Clin Immunol 2010; 126 (5): 942–9.
20. Di Rienzo V, Marcucci F, Pucinelli P et al. Long-lasting effect of sublingual immunotherapy in children with asthma due to house dust mite: a 10-year prospective study. Clin Exp Allergy 2003; 33 (2): 206–10.
21. Nelson H, Cartier S, Allen-Ramey F et al. Network meta-analysis shows commercialized subcutaneous and sublingual grass products have comparable efficacy. J Allergy Clin Immunol Pract 2015; 3 (2): 256–66.
Авторы
К.С.Павлова*
ФГБУ ГНЦ «Институт иммунологии» ФМБА России. 115478, Россия, Москва, Каширское ш., д. 24, корп. 2
*ksenimedical@gmail.com
Institute of Immunology of FMBA of Russia. 115478, Russian Federation, Moscow, Kashirskoe sh., d. 24, korp. 2
*ksenimedical@gmail.com
ФГБУ ГНЦ «Институт иммунологии» ФМБА России. 115478, Россия, Москва, Каширское ш., д. 24, корп. 2
*ksenimedical@gmail.com
________________________________________________
Institute of Immunology of FMBA of Russia. 115478, Russian Federation, Moscow, Kashirskoe sh., d. 24, korp. 2
*ksenimedical@gmail.com
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